Emergency Departments on Front Line of Opioid Epidemic (Video)

A presidential announcement Thursday declared a U.S. public health emergency because of the hundreds of people who are dying daily from overdoses involving opioids. Joseph Scott, M.D., ER medicine physician at West Kendall Baptist Hospital, says the problem is chronic and widespread.

(Video: The Baptist Health News Team hears from Joseph Scott, M.D., medical director of emergency services at West Kendall Baptist Hospital, about the opioid epidemic in America.)

“Emergency Departments in general are facing an increasing number of patients who are either accidental or purposeful overdoses from opioids,” said Dr. Scott, who is chair and medical director of emergency medicine at West Kendall Baptist Hospital. “It can be pain medication, heroin or a very powerful man made concoction.”

Dr. Scott adds that opioid overdoses are not new, but do have a new twist.

“We’ve been dealing with opioids for decades, and morphine existed long before that,” he said. “As a drug to reduce pain, opioids are very effective. The crisis we have now is having to deal with overdoses from opioids that are mixed with more dangerous substances, like fentanyl and carfentanil.”

Opioid overdoses have quadrupled since 1999, and deaths from overdoses involving opioids soared to more than 64,000 in 2016, up from 33,091 deaths in 2015, according to the U.S. Centers for Disease Control and Prevention (CDC). Florida is one of the states with statistically significant increases in drug overdose death rates from 2014 to 2015. The CDC says opioids, prescription and illegal, are the main driver of drug overdose deaths.

Fentanyl is an illegally made substance that has become a significant contributor to unintentional overdose deaths and threat to public health in the United States, according to the CDC. Another powerful synthetic drug leading to overdoses is carfentanil, which is used to tranquilize elephants and is found in what seems to be heroin. But carfentanil can be up to 5,000 stronger than heroin and is 10,000 times more potent than morphine, according to the U.S. government.

Dr. Scott says while Emergency Departments can take care of the immediate threat of death from overdose, more long-term treatment resources, like Baptist Health’s Care & Counseling Services, are needed in our communities.

‘This Epidemic is Affecting Every Community’
He encourages everyone to know the signs of opioid use and symptoms of an overdose, including constricted (small) pupils and slowed breathing. Responding immediately is the difference between life and death, he emphasizes.

“This epidemic is affecting every community, and almost everyone knows someone who’s misusing opioids whether they’re aware of it or not,” Dr. Scott said. “If you suspect someone has overdosed, especially on opioids, call 911 immediately and open their airway.”

Patients who arrive at a Baptist Health South Florida emergency center with an overdose likely receive a medication that can reverse the effects of opioids. Emergency medicine physicians at Baptist Health’s Emergency Departments work under the same guidelines when treating opioid overdoses. They started working on establishing the guidelines in late 2014, finalized and put them into effect in early 2016. The CDC recommended in mid-2016 that U.S. hospitals establish guidelines

The Baptist Health News Team spoke to Dr. Scott in the Emergency Department at West Kendall Baptist Hospital about the opioid epidemic.